Outcome comparisons between high-volume robotic and laparoscopic surgeons in a large healthcare system.

Robotic colorectal surgery has been performed for nearly a decade, but has been criticized for high cost. We sought to assess outcomes of colorectal operations performed by surgeons with higher experience in robotics and laparoscopy across a large health system. We performed a retrospective review of colon or rectal resections performed between January 2013 and May 2016 within the Providence Health and Services. Surgeons were only included if they performed 30 or more procedures with an approach per year. We assessed outcomes including operative time, hospital length of stay, complications, readmission, conversion to open rates and total direct costs. When comparing the two groups, robotics surgery had a decreased length of hospital stay, lower conversion rate, and longer operative time. There was no statistical difference between complications and rate of readmission. There was no statistically significant difference in total direct cost. These data do suggest that high volume robotic surgery can carry the benefit of a lower length of stay and lower conversion rate, while not incurring an increase in total cost, complication or readmissions.